Ophthalmology in North America: Early Stories (1491-1801)

Abstract

New World plants, such as tobacco, tomato, and chili, were held to have beneficial effects on the eyes. Indigenous healers rubbed or scraped the eyes or eyelids to treat inflammation, corneal opacities, and even eye irritation from smoke. European settlers used harsh treatments, such as bleeding and blistering, when the eyes were inflamed or had loss of vision with a normal appearance (gutta serena). In New Spain, surgery for corneal opacity was performed in 1601 and cataract couching in 1611. North American physicians knew of contralateral loss of vision after trauma or surgery (sympathetic ophthalmia), which they called “sympathy.” To date, the earliest identified cataract couching by a surgeon trained in the New World was performed in 1769 by John Bartlett of Rhode Island. The American Revolution negatively affected ophthalmology, as loyalist surgeons were expelled and others were consumed with wartime activities. After the war, cataract extraction was imported to America in earnest and academic development resumed. Charles F Bartlett, the son of John, performed cataract extraction but was also a “rapacious privateer.” In 1801, a doctor in the frontier territory of Kentucky observed anticholinergic poisoning by Datura stramonium (Jimsonweed) and suggested that this agent be applied topically to dilate the pupil before cataract extraction. John Warren at Harvard preferred couching in the 1790s, but, after his son returned from European training, recommended treating angle closure glaucoma by lens extraction. Other eye procedures described or advertised in America before the 19th century included enucleation, resection of conjunctival lesions or periocular tumors, treatment of lacrimal fistula, and fitting of prosthetic eyes.

The Use of Electrotherapeutics in Ophthalmology

“…In the early 18th century, Benjamin Franklin reported that patients who were struck by lightning developed rapidly progressing cataracts, which ultimately resulted in blindness. 7 Despite this report, electric and magnetic therapy was practiced in London for the treatment of patients with cataract in 1779. 7 In 1887, Elliot Colburn, professor of ophthalmology and otology in the Chicago Policlinic, published a paper on the use of galvanic currents to treat patients with age-related cortical cataract.…”

“…7 Despite this report, electric and magnetic therapy was practiced in London for the treatment of patients with cataract in 1779. 7 In 1887, Elliot Colburn, professor of ophthalmology and otology in the Chicago Policlinic, published a paper on the use of galvanic currents to treat patients with age-related cortical cataract. He suggested that patients without choroidal and retinal comorbidities and without systemic complications, such as diabetes, nephropathy, and cirrhosis, should expect to have visual improvement after receiving galvanic treatment.…”

“…6 The earliest uses of electricity in ophthalmology date to the 18th century, with a proliferation of electrical applications in the late 19th and early 20th centuries. 7 Nonetheless, while electrotherapy was at the forefront of medicine in the early 20th century, its use fell out of practice with the development of alternative techniques.…”

Aspiration of cataract in 1815 in Philadelphia, Pennsylvania

“…8,9 Initially, surgeon John Syng Dorsey, Physick's nephew, had operated on Shaw 3 times using the method of division, which enjoyed widespread popularity during this period. 8,10 This method involved breaking the cataract with a needle so that the remnants could be absorbed by the natural inflammatory mechanism over a period of months. 11 Dorsey described his technique as follows: after dilating the pupil with stramonium, he introduced a needle through the cornea with which "the capsule and lens are to be torn in pieces: fragments of the lens can often be pushed forward into the anterior chamber of the eye, where they speedily dissolve."…”

American Insight Into Strabismus Surgery Before 1838

“…Scudder first became known for producing and setting prosthetic eyes. Although others in America had set artificial eyes, 17 Scudder is the earliest identified oculist in America to produce them himself. He began this practice by 1823 or 1824, 18 although the prostheses were not advertised until 1827.…”